“The most dangerous illegal drug in America” is what the RAND Corp. think tank calls it. Heroin? Meth? Cocaine? No, it’s fentanyl. The synthetic opioid prescription painkiller, which is 50 times more potent than heroin, has made its way into the illicit drug market. Overdose deaths involving fentanyl and other synthetic opioids jumped tenfold between 2013 and 2018.
That shocking trend gave special urgency to recent legislation extending a ban on fentanyl-related drugs. The federal Drug Enforcement Administration prohibited them in 2018, but that ban was set to expire Thursday. Last week, the U.S. House voted 320 to 88 for a bill that would extend the policy for 15 months, rather than make it permanent as the Trump administration urged.
Until 2018, black-market producers could get around the strict federal rules on fentanyl by making molecular changes to create new compounds that weren’t covered by the agency’s rules. DEA’s sensible response was to forbid all variants to block such circumvention.
Illinois is one of the states hardest hit by fentanyl and other synthetic opioids, which claimed 1,187 lives here in 2017 — the devastating equivalent of one every seven hours. The bill had passed the U.S. Senate without a dissenting vote. So it’s perplexing that nine House Democrats from Illinois voted against the bill: Sean Casten, Danny Davis, Bill Foster, Chuy Garcia, Robin Kelly, Bobby Rush, Jan Schakowsky, Brad Schneider and Lauren Underwood.
Casten told Crain’s Chicago Business, “You can’t find any instance in history where criminalizing a drug has prevented its use.” He and fellow freshman Lauren Underwood said they prefer to focus on investments in substance abuse treatment and rehabilitation.
Measures to combat addiction and reduce demand for illegal opioids, we agree, are a sound part of any strategy to prevent overdose deaths. But that’s no reason to ease off on efforts to curb the supply. Most of the fentanyl variants come from producers in China. The administration won a notable success last year when it persuaded the Chinese government to outlaw all fentanyl-related compounds. In turn, it only makes sense for the U.S. to preserve its own prohibition.
Has the policy worked? DEA reported last year that it “has substantially slowed the rate at which new fentanyl-related substances are introduced to, and are encountered in, the illicit market.” In the first quarter of 2019 — thanks in part to Beijing’s 2018 announcement that it would go after these drugs — DEA found no new analogues showing in the illegal trade. Suppliers who found all the loopholes closed apparently had to rethink their business model.
The House opponents are correct that enforcement won’t solve everything. Education on the mortal hazards of illegal opioid use is important. So is facilitating access to treatment programs, such as those covered by Medicaid. A study published in an American Medical Association journal found that overall, states that expanded Medicaid under the Affordable Care Act (a group that includes Illinois) had fewer overdose deaths involving opioids other than methadone, compared with states that didn’t expand the program.
America’s drug overdose epidemic killed more than 67,000 people in 2018. Reducing that grim annual toll will require that every available remedy be brought to bear on the problem.
For the time being, the ban on fentanyl analogues will still be part of the effort. Before the extension runs out next year, we hope Congress will make it permanent — and that the entire Illinois House delegation will unite behind it.
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